Odległe następstwa tracheostomii przezkrtaniowej sposobem Fantoniego

Jerzy Paleczny¹, Piotr Knapik², Dariusz Maciejewski¹, Elżbieta Łoniewska-Paleczny¹

Summary
Background. Tracheostomy is a common ICU procedure used for temporary, rather than permanent management of the airway. A satisfactory outcome after decannulation and discharge is very important. In recent years, less invasive, percutaneous dilatational techniques have been introduced into clinical practice, resulting in a marked decrease in the number of long-term complications. No studies have been previously published describing the long-term outcome of the Fantoni translaryngeal technique (TLT). Methods. We have analyzed the outcome of all TLT´s performed in ICU patients who survived 6 months after decannulation, over 4 years at a single institution. A questionnaire was used, in addition to spirometry and spiral computer tomography of the trachea. Results. TLT´s were performed in 32 patients; the analysis was attempted in 10 patients who survived. The questionnaire was answered by 8 patients; two patients refused further evaluation. In two cases (25%) change of voice was reported. A spiral CT scan was performed in 7 patients revealing stenosis of the tracheal lumen in one case. Flow impairment was also diagnosed by spirometry in this case, however he had no clinical symptoms or complaints. Conclusion. We found long-term outcomes after Fantoni translaryngeal tracheostomy techniques to be satisfactory. The small number of patients did not allow for statistical analysis and/or recommendations. Tracheal stenosis may be easily diagnosed with the use of a CT scan and spirometry in the absence of clinical symptoms.

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